In the Water

Inside Florida’s Battle With the Flesh-Eating Vibrio Vulnificus

A crabber is Florida's latest casualty of the flesh-eating bacteria Vibrio Vulnificus. Jacqui Goddard on the ‘horrific’ infection that ‘crept through his body like acid’ and how it spreads.

Henry Konietzky thought little of it when he stepped on some ants just before wading knee-deep into Florida’s saltwater Halifax River to set crab traps on a Saturday afternoon.

But severely aching legs and a developing sore on his ankle woke him at 2 a.m. the next day. By 6 a.m., lesions were spreading across his body. Last Monday, after just 28 hours in hospital, the 59-year-old was dead, the ninth person killed in Florida this year by the waterborne, flesh-eating Vibrio Vulnificus.

One of the world’s most deadly bacteria, it is thought to have entered his foot through the minute puncture wound of an ant bite, then set up an infection that “crept through his body like acid,” destroying tissue and ultimately shutting down organs, said his shell-shocked widow Patty, of Palm Coast.

“It’s the most horrific thing I have ever seen in my life,” she added.

Yet the bacteria has many years’ history here and along the Gulf Coast states, where public-health officials are working to increase awareness and reduce risks relating to the microscopic killer. With each new tragedy that unfolds comes grief and heartache, but also an opportunity to educate.

In 2013 to date, the Florida Department of Health (DOH) has recorded 27 cases of Vibrio Vulnificus infection in humans, including the nine fatalities. That toll matches precisely the toll wreaked on the state in the whole of last year. In 2011, there were 35 cases and 10 deaths.

The Sunshine State has consistently accounted for more than half of the infections in the entire Gulf Coast region, which average around 50 a year in total. A naturally occurring bacteria related to cholera, it is transmitted in one of two ways; either through ingestion of raw shellfish—generally oysters—or via open wounds in water.

What happens next is influenced by the victim’s medical history. “People who have underlying health conditions, like a poor immune system or especially chronic liver disease, can develop bloodstream infections that are fatal up to 50 percent of the time,” says Dr. Carina Blackmore, interim state epidemiologist at the Florida DOH.

“Studies have shown that people with pre-existing medical conditions are about 80 times more likely to develop these severe bloodstream infections than healthy people.”

Florida’s abundance of retirees and water-based activities, popularity as a tourist destination, and plentiful breeding grounds for the bacteria—which thrive in warm, salty water—are among the factors that combine to make it the No. 1 state for Vibrio Vulnificus infections.

“The last thing we want to do, though, is make people think that if they go to the beach they’re going to die,” said Dr. James Oliver, a professor of biology at the University of North Carolina Charlotte and the world’s foremost expert on Vibrio Vulnificus. “Look how many people go to the beach in a year, and look how many people fall victim to this in a year. It’s easy math,” he stresses.

He has studied the Vibrio genus of bacteria for more than 40 years and still finds it eminently fascinating. Vibrio Vulnificus divides once every 20 or so minutes—a particularly rapid rate that accounts for its swift takeover of the human body once it has won access.

For George Clarke, 79, a fisherman now fighting for his life in a Jacksonville hospital, it took just a few hours for things to turn bad after the bacteria entered through a nip on his right arm that was inflicted by a crab in the Amelia River two weekends ago.

At 4 a.m. that Sunday, he woke with severe shakes and his forearm “felt like it was on fire,” said his wife, Shirley. It turned swiftly black. Most of the skin has now gone as surgeons battle to keep the infection from spreading, and he is on four antibiotics. His distraught wife can only holler in his ear as he lies unconscious that he should keep fighting. “We’ve got a wedding anniversary to celebrate on Tuesday,” she reminds him.

Richard Garey, 56, a soccer coach in Gonzales, Louisiana, knows how it feels. His wife “watched me dying in front of her” after he picked up a Vibrio Vulnificus infection in June, after gashing his foot on barnacle-covered rocks on Grand Isle.

For a day or so, he just felt rough. “Then it hit that critical mass where things went south very quickly. It’s eating your flesh and the toxins it releases in doing so are what overloads your system,” he explains, recalling how medics could not even get a blood pressure reading for him when he got to hospital, suffering from septic shock.

“I was on the edge. I was kind of in that world, and kind of outta that world…The nurse was saying ‘Don’t go, don’t go, keep fighting,’” he says. “I felt like I had just two heartbeats left in me.”

Without even waiting for the results of a laboratory culture, a doctor recognized the signs and symptoms of Vibrio Vulnificus—including the smell of the necrotizing flesh. The swift diagnosis saved his life, and his infected limb. “They told me if it had been another three to four hours, they would have had to take my leg off,” he said.

Four months later, he is still undergoing intense physiotherapy. He has undergone seven surgeries and one skin graft. Photographs of his foot and lower leg at their worst resemble something from a horror movie.

“Who knew this could happen,” he said. “I’ve been in those marshes thousands of times, over 45 years, and a bacteria I’d never heard of came along and put me in this life-or-death fight.”